Exploring the Association Between Exposure to Suicide and Suicide Risk Among Military Service Members and Veterans

Authors
Hom, M. A. Stanley, I. H. Gutierrez, P. M. Joiner, T. E.
Publication year
2017
Citation Title
Exploring the association between exposure to suicide and suicide risk among military service members and veterans
Journal Name
Journal of Affective Disorders
Journal Volume
207
Page Numbers
327-335
DOI
10.1016/j.jad.2016.09.043
Summary
Suicide has a profound impact on surviving family members and friends, although few research has examined this issue in the military population. By combining data from 15 independent studies, this study examined the association between exposure to suicide and suicide risk in Service members and Veterans. Results revealed an elevated risk of suicide in military personnel who have been bereaved by suicide.
Key Findings
Compared to participants who did not know someone who committed suicide, those who knew someone who committed suicide were more likely to report current suicidal symptoms and history of suicidal thoughts and behaviors.
The closer a participant was to a person who committed suicide, the more likely that the person would have future suicidal attempt.
Participants who reported greater negative impacts of suicide death on their lives were more likely to have current suicide ideation.
Implications for Program Leaders
Offer workshops to military families who had been exposed to suicide in order to reduce the negative effects of suicide exposure
Provide support groups for Service members who were exposed to suicide so that they can help and support each other
Disseminate information regarding suicidal symptoms and behaviors that Service members should watch for and professional institutions that may help
Implications for Policy Makers
Build awareness among military families around the importance of promoting positive coping in Service members
Continue to support prevention efforts that meet military Service members’ unique needs
Support training for professionals who work with Service members so that they are aware of the relationship between suicide exposure and suicide risk
Methods
Data for the study were aggregated from 15 independent studies with various recruitment methods (e.g., flyers, provider referrals, etc.).
All participants completed the same battery of measurements, including suicide exposure and bereavement experience, suicidal symptoms, suicidal behaviors, thwarted belongingness, and history of non-suicidal self-injury.
Data were analyzed to examine the association between exposure to suicide and suicide risk.
Participants
A total of 1,753 Service members and Veterans were included in the study; the participants were mostly male (82%) with an average age of 33.44 years (age range = 18-88 years, SD = 13.38).
Most participants were White (65%), followed by Black (20%) and others (3%); 12% of the participants declined to state their race/ethnicity.
Participants’ military branches were: Army (70%), Navy (13%), Marines (11%), Air Force (4%), and other (2%); the current military status (e.g., Active Duty or Reserve) and rank of the participants were not indicated.
The majority of participants (57%) reported knowing someone who died from suicide.
Limitations
The cross-sectional design of the study made it hard to examine the causal relationship between exposure to suicide and suicide risk.
The degree of participants’ exposure to suicide was not collected, therefore it was impossible to investigate if greater exposure were associated with more severe suicidal risk.
Participants’ military status and rank were not collected, therefore the potential effects of military status and rank on the association between exposure of suicide and suicide risk were unknown.
Avenues for Future Research
Collect longitudinal data to examine the causal relationship between exposure to suicide and suicide risk
Study if age, gender, military status, and rank have any effect on the association between exposure of suicide and suicide risk
Explore prevention methods that could decrease Service members’ and Veterans’ suicide risk after being exposed to suicide
Design Rating
2 Stars - There are some flaws in the study design or research sample, but those flaws do not significantly threaten the ability to make conclusions based on the data.
Methods Rating
2 Stars - There are no significant biases or deficits in the way the variables in the study are defined or measures and conclusions are appropriately drawn from the analyses performed.
Limitations Rating
2 Stars - There are a few factors that limit the ability to extend the results to an entire population, but the results can be extended to most of the population.
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
Background: Past research suggests that suicide has a profound impact on surviving family members and friends; yet, little is known about experiences with suicide bereavement among military populations. This study aimed to characterize experiences with suicide exposure and their associations with lifetime and current psychiatric symptoms among military service members and veterans. Methods: A sample of 1753 United States military service members and veterans completed self-report questionnaires assessing experiences with suicide exposure, lifetime history of suicidal thoughts and behaviors, current suicidal symptoms, and perceived likelihood of making a future suicide attempt. Results: The majority of participants (57.3%) reported knowing someone who had died by suicide, and of these individuals, most (53.1%) reported having lost a friend to suicide. Chi-square tests, one-way ANOVAs, and logistic regression analyses revealed that those who reported knowing a suicide decedent were more likely to report more severe current suicidal symptoms and a history of suicidal thoughts and behaviors compared to those who did not know a suicide decedent. Hierarchical linear regression analyses indicated that greater self-reported interpersonal closeness to a suicide decedent predicted greater self-reported likelihood of a future suicide attempt, even after controlling for current suicidal symptoms and prior suicidal thoughts and behaviors. Limitations: This study utilized cross-sectional data, and information regarding degree of exposure to suicide was not collected. Conclusions: Military personnel and veterans who have been bereaved by suicide may themselves be at elevated risk for suicidal thoughts and behaviors. Additional work is needed to delineate the relationship between these experiences.
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